Today’s post is written by Kasaundra Trout. Kasaundra has been a doula for 3 years, serving Salt Lake and Utah Counties. She has volunteered as Vice President of Utah Valley Moms of Multiples and we enjoyed having her on the Utah Doula Association Board as Co-Secretary in 2016. She is passionate about her clients and their emotional wellness and has a program called “The Pregnancy Box” that she uses with them to help process the many emotions surrounding pregnancy and birth. She is on maternity leave for the rest of 2017, but plans to restart her pregnancy and postpartum circles this summer, so keep an eye on her website, edensdoula.com, for more information.

I expected to fall in love with my babies the moment I found out I was pregnant. When that didn’t happen, I began to think that maybe something was wrong with me. Babies are a good thing, right? Besides annoying pregnancy symptoms, I should be overflowing with this newfound maternal love, right?

As a doula, I do my best to help women know that there is no wrong way to feel about a pregnancy. Having spent the last 9 months with my own pregnancy, I learned how much it sucks to have to take your own advice. Be that as it may, I was grateful to have my doula bag of tricks. Here is what I discovered…

Mental health is a priority.

So many women don’t know that perinatal anxiety and depression exist. The changing hormones in your body can mess with your ability to feel that surge in love you were expecting. Knowing that this was a factor in my pregnancy helped me take the steps necessary to balance my hormones. It’s a hard battle when you’re fighting against your own body.

Talk about it.

Difficulty connecting with your baby can bring on a lot of emotions. Confusion, grief, anger, anxiety, etc.—just to name a few. Trying to bury them only makes the dirt mound you’re sitting on taller. Get it out. Tell your partner, your close friend, your therapist, or just anyone you feel safe with! You never know… they might just have the words or hug you were looking for.

Get creative.

It’s time to connect thoughts of your baby with something you enjoy. For me, one of those things is music. I picked a song for my baby and listened to it often. When I listened to that song, it’s like a brief window would open up and I could finally feel my baby. I found that picking a name, buying jewelry to wear as a reminder of her, or even learning a new hobby so I could crochet her a blanket was helpful. Don’t be afraid to try new things.

Affirmations are key.

One of the things I make sure my clients know how to do is write affirmations. Before I began learning about birth, I used to write them off as hippy mumbo jumbo. But lucky us, they are actually useful to hippy and mainstream mothers alike! The truth is that they are tools for rewriting your inner dialogue. When we fixate on a problem, we are putting that negative thought on loop through our brain. It becomes a self-fulfilling prophecy. To take the first step in changing your story, you have to change the narrative. Instead of “I can’t”, focus on “I can” or “I am”. Write it down. Tape it on the mirror. Say it out loud. Take the time to give yourself your best chance.

If you are struggling to feel close to your baby as they grow within the womb, my heart goes out to you. I know that frustration. I’ve seen it in the eyes of the women I have cared for. You are not alone. Your feelings may change, and they might not. Mine were complicated. But do you know what my first words were to my baby?

“You’re real.”

I may not have already had intimate knowledge of who she was when they laid her in my arms, but she was finally there. I have 18 years to get to know this little one. It hasn’t taken us that long to fall in love with each other, but there was no rush. We had time. And so do you.

***This week’s post is written by a woman in our community that has chosen to remain anonymous. It is real and honest and may be triggering for some readers.***

Secondary infertility is defined as the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child does not involve any assisted reproductive technologies or fertility medications.

I never imagined that I would be researching that definition. Achieving a pregnancy wasn’t a challenge for me before now. After all, I had muddled through sleepless nights nursing my second son to sleep for the umpteenth time, wishing for a full-night’s rest. I never envisioned myself meeting with doctors and nurses discussing my period regularity and intercourse frequency because after all I had already celebrated first steps milestones with my first born. Looking back on myself, as I remember watching the little pink test reveal a plus sign for the first time in my life, I never in my wildest imagination thought that I would be that person speeding my husband’s sperm sample up to the lab, hoping to make the cut off time. But here I am. Or here we are for that matter, because infertility affects us both.

I knew something was not right after only 6 months of trying to become pregnant with what I thought would be my third child. I’d started charting my temperature months in advance so I could pinpoint my ovulation down to a 24-hour window. I read all the books about getting pregnant and fertility leading up to when we wanted to start trying for that baby. Even though I’d gotten pregnant twice before so easily, I researched everything I could about getting pregnant. I was planning it all out in advance. I used coupon codes for free nursing covers and pillows, bought reusable breast pads, and started a ‘wish list’ on Amazon of all the baby gear we would need again. I broke down and finally looked at minivans on the weekends in preparation for our growing family. But when I didn’t get pregnant month after month, a voice in the back of my mind nagged at me. I chalked it up to being older. “Not everyone gets pregnant on the first or second try like I did with my two boys. Give it time,” I thought. But still the little voice in the back of my head kept at it. Something wasn’t right. Something was wrong with me, I had somehow become broken.

I never in my wildest imagination thought that I would be that person speeding my husband’s sperm sample up to the lab, hoping to make the cut off time. But here I am. Or here we are for that matter, because infertility affects us both.

As it turns out, it wasn’t me after all. After driving myself crazy for months, I Googled my husband’s medication with the word infertility attached to it and found my answer. The testosterone his doctor had prescribed for borderline low-T had wiped out his sperm counts. I knew what the results would be even before I called the doctor’s office requesting a sperm analysis. “No sperm to be counted” is what it actually said when I read through the results. We were put in touch with a male factor infertility doctor and my husband was put on Clomid to help repair the damage that was done.

We went to countless appointments, we were referred to other doctors, medication was adjusted, sperm was analyzed, and almost three years later we were given a final word. They were out of ideas and we were at a crossroads. If we were ever going to have any more biological children we would have to do IVF and intracytoplasmic sperm injection, aka ICSI, to the tune of a hefty penny. A hefty penny we don’t have. Could we get that penny? Probably, but it would greatly affect the kids we have already. We had to think about them and not just us and our desire for more children.

I didn’t choose to be “done at two.” We had always talked about more. We had talked about four.

Ranges of emotions still run through me today. I am angry at the doctor who carelessly gave my husband the drug that caused this to change our family plans, without telling us possible side effects of the medication. I feel a sense of relief because I know exactly where we stand and what we have to do if we choose to have more babies. And yet I feel confused. I am not infertile. I don’t deserve to wear that badge. I haven’t suffered enough. I already have children, I am not one of those women who cry and pray and work two jobs and sell their belongings saving up for IVF only to have it fail and then try again before finally welcoming the long awaited bundle of joy into their home. I am already a mother. But I don’t fit into the other category either. I didn’t choose to be “done at two.” We had always talked about more. We had talked about four.

I watched family members and friends announce their pregnancies, and I was so completely happy for them. I didn’t cry because they were pregnant and I wasn’t. I didn’t feel jealousy. I already had kids, I’d already given birth. I’d already spent late nights rocking my tender souls, snuggling them a little longer than what they really needed, savoring the stillness, memorizing their sweetness, and listening to them as they sighed in their sleep.

“Done?” I thought, “Am I done? Will there really be no more tiny humans growing in my belly? Will I never nurse another baby? Am I done with diaper bags? Do I look like a woman who is done having babies?”

So why, when a family member commented about me being done having babies at a young age, catch me so off guard? “It must be so nice to be done having kids at such a young age! You probably love how easy it is to travel now that they are getting bigger and you don’t have any more diaper bags to carry around.” she’d said. “Done?” I thought, “Am I done? Will there really be no more tiny humans growing in my belly? Will I never nurse another baby? Am I done with diaper bags? Do I look like a woman who is done having babies?” I was so confused. I smiled and shrugged it off and admitted that a diaper bag free life was actually pretty sweet, but inside I felt heavy. It wasn’t my choice to be done. It wasn’t my husband’s choice. That choice was taken from us.

My husband has hard days sometimes too, he blames himself. I blame his doctor. People seem to always want to know who’s “fault” it is when a couple can’t conceive. We decided we would keep our infertility private. A select few friends know, but otherwise we have kept it to ourselves. We didn’t want advice, or input as to what to do with our infertility. We didn’t want people to tell us to just be grateful for the kids we already have. We didn’t want the sympathy either, if that is even possible to understand. We weren’t mourning, we were just living. Everyone who goes through infertility has such a vastly different journey. My experience is so very different from another woman’s journey. And no one can compare their suffering to another. My journey is my own, and I’ve found lessons along the way.

If I had known those moments were numbered and final, I might have tried to capture them, forever to look back on. It wasn’t my choice to journey down this path of secondary infertility, but I can choose to live my life in ways that bring me joy and happiness and that help me feel complete.

It has taught me to be more present. I used to get so caught up in what we will be, what we were going to become, that I didn’t realize what we were at that moment. I look at my boys in a new bright light. They are my only two opportunities to be a good mom, and to thoroughly, completely enjoy the humans that they are. Night time tickles with my seven year old are a little bit longer; conversations are deeper – as deep as a nine year old tornado-child can be. Family vacations are valued that much more, because this is my family right here and now.

I’m becoming more and more okay with “being done” it’s so much earlier than I expected, but I’m finding it easier to accept. I’ll admit there is always a thought of “maybe it will still happen, maybe there will be a miracle” whispering in my head, but we are choosing to move on. For us, there will be no more babies. I will forever miss the opportunity to nurse another baby, it was my favorite thing to do. I even enjoyed pumping at work! I will always wish for the chance to sit in another moonlit room watching my baby sleep. If I had known those moments were numbered and final, I might have tried to capture them, forever to look back on.

It wasn’t my choice to journey down this path of secondary infertility, but I can choose to live my life in ways that bring me joy and happiness and that help me feel complete.

Our guest blogger this week is Charity Wheeler. Charity owns Pure Love Doula and serves Utah and Salt Lake Counties, as well as surrounding areas. She joined the UDA in 2016and is currently serving on the Board as the Utah County Representative. She loves supporting families and helping parents feel confident and empowered during their birth experience.

Using Exercise & Peanut Balls in Pregnancy and Birth

When I was pregnant with my first child I bought a birth ball mostly because I had heard they were good, but I had no idea why. I would sit and bounce on it while watching “Gilmore Girls”, and towards the end of my pregnancy, I bought one to sit on at work as well. You’d think the fact that I owned two of them I would have known more about them, but I didn’t. And because I was so unfamiliar with how to use birth balls I didn’t utilize them during my daughter’s birth.

Since becoming a doula, I make an effort with my clients to make sure you feel comfortable using both a birth and peanut ball. I bring them into your home and practice different positions with you so that when you are in labor you’ll feel comfortable and confident using these amazing tools.

During pregnancy and birth your body releases an amazing hormone called relaxin. Relaxin makes it so the ligaments in your pelvis can relax and open for the birth of your baby. But, if you aren’t getting into positions that keep you in alignment and allow your pelvis to open, relaxin can be counterproductive.

The optimal positions for you to be in during labor (positions most women will naturally get into) are positions that help open the pelvis, allow movement, and use gravity to move baby down. One of the things I love most about the use of birth and peanut balls is that they allow you to be in more restful positions while helping you maintain optimal alignment and positioning for birth.

Birth ball positions to practice during pregnancy and use during birth:

Sitting on a birth ball doing hip circles, bouncing, swaying back and forth. In this position you can lay over a bed/couch arm, or a support person. Or you can have a support person behind you and lean back on them.

Kneeling on the floor leaning over a birth ball. Many women like being on all fours. It’s great for alignment and this is an adaptation of that.

When it comes to a peanut ball, most people have never seen one before entering a hospital, so are hesitant to use one because it’s so foreign. If you want to be in a side lying or sitting position the peanut ball is a must. Remember how relaxin helps relax the ligaments of the pelvis? Using a peanut ball when sitting or laying will help keep your pelvis open. If you choose to get an epidural make sure you ask for a peanut ball. Your support team can help position the peanut ball under one knee to help keep your pelvis open.

These are my favorite ways to use a peanut ball during labor:

Side lying with the peanut ball between your knees.

Sitting or slightly reclined with the peanut ball under one knee.

I know the peanut ball looks really awkward but whenever I have a client practice these positions they always say they want to purchase one–and some do!

If you’d like to purchase a birth ball you can often find them at TJMaxx, Ross, or any sporting good store. I am strictly an online shopper since I have two young children so I ordered both my peanut and birth ball on Amazon.

And a special thank you to the amazing Lucy and Seth that were my models for the pictures! She gave birth to her beautiful baby boy the next day and used both the birth and peanut ball during her labor.

Pregnancy is full of so many new and beautiful things (and let’s be real here… a few not so beautiful things.) With those things come questions. Oh, so very many questions. As doulas, we hear a lot of these and we have some incredible members of the Utah Doula Association here to answer a few for you.

But first: A disclaimer- We are not medical providers. Please talk to your doctor or midwife about any questions/concerns you have. After all, that’s one of the reasons you’ve hired them… They want you and your baby to stay happy and healthy!

Now onto the questions! We chose the questions we see and hear most often from our clients and community and collected answers from some of our local doulas.

What foods should I avoid?

”Eating well-balanced meals during pregnancy is very important for you and your developing baby. Most foods are safe; however, there are some foods that should be avoided. Here is a list of the top foods to avoid during pregnancy.

Fish containing high levels of mercury including: shark, swordfish, king mackerel, and tilefish. Canned, chunk light tuna usually contains less mercury than other tuna, but should be limited to less than 6 ounces per week.

Organ meat more than once per week

Raw eggs or any foods containing raw eggs

Unpasteurized milk, cheeses, or fruit juice

Salads from the deli containing eggs or meat

More than 200 mg of caffeine per day

Alcohol

Unwashed produce

Raw or undercooked sprouts

Junk foods

If you have questions about the safety of a certain food, be sure to speak with your care provider.”

Can I still workout?

“I would say always check with a doctor before beginning a new exercise routine, if you have been
active before it is ok to continue being active, and be sure to talk to your instructors and ask them for modifications if you do any type of high impact workouts. Yoga, moderate cardio, and moderate weight training have shown to actually be beneficial in pregnancy.”

What should I put in my hospital bag?

“Of course some of the more obvious items come to mind: toothbrush, phone charger and hair brush. But maybe you have a comfort item such as a blanket or picture that relaxes you? Is your pillow amazing and you can’t sleep without it? Pajamas, slippers and a bathrobe can help you feel more comfortable in the sterile environment of a hospital. Bring whatever is that helps you feel like you. It could be mascara, lip gloss or a curling iron. Hospitals are dry so bring lotion and chapstick as well. And don’t forget the car seat!!”

What is a birth plan and how do I write one?

“A birth plan is a tool for communicating your needs and desires for your birth experience to your doctor, nurses, midwife, and/or doula. When writing yours, consider how you want your birth to be. What would you like to have as part of it? What procedures would you like to avoid? If you aren’t sure, Google some examples of birth plans to see what’s included. A good rule of thumb is to keep it to one page with bulleted points. Clear and concise. Focus more on what you DO want than what you don’t. And make sure your doctor, spouse or partner, and anyone else supporting you reads it before you go into labor.”

How can I make sure I stay hydrated?

“Staying hydrated is so important for mother and baby. Get yourself a leak-proof water bottle that you LOVE (you’re more likely to use it if you love it!) Keep it with you at all times to sip throughout the day. Make a habit of taking a few swallows every time you use the bathroom, whenever you receive a text, when you feel your baby move, or whatever other small task will help you to remember. If plain water is hard to drink, consider adding a squeeze of lemon, a few muddled mint leaves, or a small handful of fresh or frozen berries. Try eating fruits and vegetables with a high water content too. Apples, oranges, melons, leafy greens, and celery are great options.”

What stretches can help relieve pregnancy aches and pains?

“Aches and pains are very common in pregnancy – specifically and especially in the low back. Before I get into some of the stretches that may help, I want to say that if you are having debilitating or persistent pain you should bring it up with your care provider who can work with you to set up an exercise plan specific to you and your needs. If you’re not worried about the pain and simply seeking some comfort, here are some ideas for you: pigeon pose, modified or not, is a great pose to both externally rotate the hip and get a nice stretch in the low back – two things that will help bring relief. Hamstring stretches, like a standing or seated forward fold, will also stretch the low back. Hugging the knees into the chest – as wide as you need your knees to accommodate your growing belly – or some gentle twists can also be helpful to the low back. Three great strengthening exercises for the low back are reverse plank or simple reverse table-top position, bridge pose, and staff pose – strengthening the area may be just what you need for some added support to hold up your growing uterus and the extra bit of weight that makes up your sweet baby – or babies!”

How do I use a birthing ball/peanut ball?

“Birthing and peanut balls are amazing tools to use both during pregnancy and labor. Sitting on a birth ball can help you maintain good posture and keep your pelvis open so baby can more easily get into an optimal position for delivery. Many women find that during the early stages of labor they can help trigger contractions by bouncing on a birthing ball or doing hip circles while sitting on one. Peanut and birthing balls are also fabulous ways to be in a more resting position during labor, while also helping with maintaining good posture, positioning, and opening of the pelvis. Some great restful positions include: lying on your side with a peanut ball between your legs, sitting on a birth ball while lying/leaning over a bed or couch arm, and sitting in a reclined position with a peanut ball under one knee.”

How do I write a postpartum plan?

“Expectant couples can spend months researching their perfect birth, but many fail to consider the postpartum period and it can take mothers by surprise. Because the postpartum period inhabits so much and lasts for months, if not years, it’s essential to plan accordingly. A postpartum plan is similar to your birth plan. Here are a few things to consider…

Who can offer assistance by rallying family and friends or choosing a postpartum doula to support you?

How long will your partner be off work to bond with baby and help mom?

Who can help schedule the delivery of meals?

Who can transport older children to and from school?

Plan ahead for dates and travel arrangements for out of town family visits.

Who can come pick up toddlers and have playdates while you rest?

Can you pay for a housecleaning service?

How long will your maternity leave be?

Do you need to pump extra while on maternity leave to have a milk storage?

Do you need to start interviewing nannies or daycare providers?

Things to be done at home before your baby is here…

Prepare a bunch of freezer meals. Fill your freezer!

Buy a lot of healthy snacks to keep on hand when mom isn’t able to cook.

What if I am not sure about the care provider that I have chosen… especially late in my pregnancy?

“Trust your gut feeling. If you are questioning things about your care provider, look into other options. It’s not too late, even near the end of pregnancy, to change your mind. You might find that it’s the best decision that you’ve ever made. It certainly does not hurt to look into your options. There are usually red flags during the pregnancy if your care provider is not supportive of your birthing choices. Don’t ignore those. It is one of the most important choices that you can make in your whole birthing experience. Even if you are in labor at a hospital and you don’t like your nurse don’t feel bad about asking for a new one.”

When will I go into labor and what happens if I go over my due date?

“These may feel like the most pertinent questions as you near your birthing time. We are so used to planning and knowing what happens next and when. Being used to scheduling everything can make the unknown of the birthing time seem elusive and perhaps always on the horizon. You may not find it comforting to be told things like, ‘Baby will come when they are ready.’ Or even, ‘It will happen when it happens.’ It won’t take away the guesswork of the unknown, but it may help you breath easier knowing that the time frame during which baby can arrive really is not easily written down to a certain day. So what do you do if you go over your due date? This is a perfect question to ask your care provider. His/her answer will give you a good idea about their policies regarding ‘over term’ births and if their policies match how you would handle the situation. Some providers may begin suggesting induction as early as 39 weeks. Others will follow your lead to wait for baby to come on their own as long as everyone is looking healthy and strong. When making a decision between induction and waiting for labor to occur spontaneously, it is important that you gather all the information necessary to make a decision for you and your baby. ACOG’s (American College of Obstetricians and Gynecologists) current recommendation is that induction based on due dates is not recommended before 39 weeks, nor 39-41 weeks unless the cervix is deemed favorable. Ultimately, choosing to wait for baby to come on their own is the safest option for both mother and baby, as it lowers the chance of birthing by cesarean section, and shows improved outcomes for both mother and baby. Since there is no magical number for knowing when your baby is fully developed and ready to be born, leaving it up to him or her to choose their birthing time, when possible, is ideal.”

How can I prepare for my VBAC?

“Read pregnancy and vaginal birth after cesarean books. I think some really good ones are The VBAC Companion by Diana Korte, Open Season by Nancy Wainer Cohen, Birthing From Within by Pam England, and Ina May Gaskin’s Guide to Childbirth. Consider registering for VBAC specific courses in an independent prenatal program. These can be refresher courses if you have taken courses before. I’d also recommend participating in ICAN. It is a support group for women that have had a previous cesarean. They are amazing, and a wonderful free resource!

Enlist the encouragement of a supportive care provider. Find a caregiver/hospital who already provides the options you want, and doesn’t need to be convinced. Find someone who believes in you and your body’s capability to birth your baby, in VBACs, has a VBAC success rate over 75%, and a cesarean rate that is lower than the community average. If possible, consider having a midwife as your primary caregiver. Midwives have a very low rate of cesarean birth. If you are unsure about anything, get a second opinion. Trust your inner strength and knowledge.

Hire a doula/labor assistant/support person. It is worth every penny to be reassured during labor by someone who believes birth is a natural function. This person will have supportive non-medical skills to help you through labor for the birth you want. This person will assist you from the day you hire her right through postpartum, and provide in person support from the onset of labor until you have settled in to cuddle with your baby.

Throughout pregnancy, practice relaxation. Your body has muscle memory and the more you practice releasing the muscles in your pelvic floor, legs, and buttocks the less you will have to ‘convince’ your body to do while in labor. Use affirmations such as ‘each contraction strengthens my baby and me.’ Or ‘I will birth my baby vaginally, naturally, and joyfully.’ Discuss everything that is important to you with your care provider, putting it all into your birth plan. Make extra copies to be put in your chart. Know your hospital’s VBAC policies and negotiate well before the birth for anything different. Your doula will happily discuss with you what to put in the plan if you have any trouble at all writing it. Research your options. Talk with your birth partner.